- Best treatments for gonarthrosis
- How is Physiotherapy for Gonarthrosis
- Does gonarthrosis cause disability?
- Who is most at risk of having
Gonarthrosis is knee arthrosis, common in people over 65 years of age, although the most affected are women during menopause, which is usually caused by some direct trauma, such as a tumble in which the person falls with the knees on the floor, for example.
Gonarthrosis can be classified as:
- Unilateral - when it affects only 1 knee Bilateral - when it affects 2 knees Primary - when it is not possible to discover its Secondary cause - when it is caused by overweight, direct trauma, dislocation or fracture, for example. With osteophytes - when small bone calluses appear around the joint With reduced intra-articular space, which allows the femur and tibia to touch, causing intense pain; With subchondral sclerosis, which is when there is degeneration or deformity of the tip of the femur or tibia, inside the knee.
Gonarthrosis is not always curable, but it is possible to decrease pain, increase range of motion, improve quality of life and well-being of the patient with the treatment that can be done with analgesic and anti-inflammatory drugs and with daily sessions physiotherapy, which should be started as soon as possible. Treatment time varies widely from one individual to the next, but will never be less than 2 months.
Best treatments for gonarthrosis
The degrees of gonarthrosis, according to the classification of Kellgreen and Lawrenc, are in the following table:
| Gonarthrosis characteristics seen on X-ray | Best treatment | |
| Grade 1 | Smaller doubtful joint space, with possible osteophyte at the edge | Weight loss + water aerobics or weight training + anti-inflammatory ointments to apply to the pain site |
| Grade 2 | Possible narrowing of the joint space and the presence of osteophytes | Physiotherapy + anti-inflammatory and analgesic remedies |
| Grade 3 | Proven joint narrowing, multiple osteophytes, subchondral sclerosis and bone contour deformity | Physiotherapy + medicines + Corticosteroid infiltration in the knee |
| Grade 4 | Severe joint narrowing, severe subchondral sclerosis, bone contour deformity and several large osteophytes | Surgery to put prosthesis on the knee |
How is Physiotherapy for Gonarthrosis
Physiotherapeutic treatment of gonarthrosis must be done individually, because what is indicated for one patient is not always suitable for the other. But some resources that can be used are TENS, ultrasound and infrared, in addition to bags of warm or cold water and exercises indicated by the physiotherapist.
Techniques for joint mobilization and manipulation are also indicated because they increase the production of synovial fluid that internally irrigates the joint and reduces chronic pain. When the person has changes such as imbalance, poor posture and deviations of the knee inwards or outwards, exercises that improve posture and correct these deviations can be used, such as global postural reeducation, for example.
The most indicated exercises are those of muscle strengthening with elastic bands or weights that can vary from 0.5 to 5 kg, depending on the degree of strength that the person has. Less weight and greater repetition are ideal for decreasing muscle stiffness and can be performed to strengthen the front, back and sides of the thigh. Finally, stretching for the thigh can be performed. See some examples of knee arthrosis exercises.
To help the person walk and move around the house, crutches or canes can be recommended to better distribute the body's weight, reducing the pressure on the knees.
Does gonarthrosis cause disability?
People with grade 3 or 4 gonarthrosis may find it difficult to work due to constant pain and the impossibility of standing and holding weight, so when treatment with physiotherapy, medications and surgery is not enough to restore quality of life and enable the work that the person already did, the person can be considered invalid and retire. But normally these degrees of gonarthrosis only happen in people over 65, when she is already retired.
Who is most at risk of having
Women are usually affected after age 45 and men after age 50, but virtually all elderly people over 75 suffer from knee arthrosis. It is believed that knee arthrosis can appear early, before age 65 in the following situations:
- Menopausal women; People with osteoporosis; In case of vitamin C and D deficiency; People who are overweight; People with diabetes or high cholesterol; People who have very weak thigh muscles; In case of rupture of the anterior cruciate ligament or rupture of the meniscus in the knee; Changes such as genovaro or genovalgo, which is when the knees are turned inwards or outwards.
Symptoms of knee pain and cracking can appear after a fall with the knee on the floor, for example. The pain usually arises when making some effort or doing physical activity, but in more advanced cases it can remain for almost the entire day.
In people over 65 years of age, the presence of small osteophytes, which can be seen on the knee X-ray, may indicate greater severity of symptoms and need for treatment with physiotherapy, and in more severe cases surgery to place a prosthesis on the knee can be indicated.
